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Resting-State Functional Connectivity and Cognition After Major Cardiac Surgery in Older Adults without Preoperative Cognitive Impairment: Preliminary Findings.

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Date
2017-01
Authors
Browndyke, Jeffrey N
Berger, Miles
Harshbarger, Todd B
Smith, Patrick J
White, William
Bisanar, Tiffany L
Alexander, John H
Gaca, Jeffrey G
Welsh-Bohmer, Kathleen
Newman, Mark F
Mathew, Joseph P
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(11 total)
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Abstract
OBJECTIVES: To look for changes in intrinsic functional brain connectivity associated with postoperative changes in cognition, a common complication in seniors undergoing major surgery, using resting-state functional magnetic resonance imaging. DESIGN: Objective cognitive testing and functional brain imaging were prospectively performed at preoperative baseline and 6 weeks after surgery and at the same time intervals in nonsurgical controls. SETTING: Academic medical center. PARTICIPANTS: Older adults undergoing cardiac surgery (n = 12) and nonsurgical older adult controls with a history of coronary artery disease (n = 12); no participants had cognitive impairment at preoperative baseline (Mini-Mental State Examination score >27). MEASUREMENTS: Differences in resting-state functional connectivity (RSFC) and global cognitive change relationships were assessed using a voxel-wise intrinsic connectivity method, controlling for demographic factors and pre- and perioperative cerebral white matter disease volume. Analyses were corrected for multiple comparisons (false discovery rate P < .01). RESULTS: Global cognitive change after cardiac surgery was significantly associated with intrinsic RSFC changes in regions of the posterior cingulate cortex and right superior frontal gyrus-anatomical and functional locations of the brain's default mode network (DMN). No statistically significant relationships were found between global cognitive change and RSFC change in nonsurgical controls. CONCLUSION: Clinicians have long known that some older adults develop postoperative cognitive dysfunction (POCD) after anesthesia and surgery, yet the neurobiological correlates of POCD are not well defined. The current results suggest that altered RSFC in specific DMN regions is positively correlated with global cognitive change 6 weeks after cardiac surgery, suggesting that DMN activity and connectivity could be important diagnostic markers of POCD or intervention targets for potential POCD treatment efforts.
Type
Journal article
Subject
anesthesia
brain
cardiac surgical procedures
cognition
functional neuroimaging
Permalink
https://hdl.handle.net/10161/13329
Published Version (Please cite this version)
10.1111/jgs.14534
Publication Info
Browndyke, Jeffrey N; Berger, Miles; Harshbarger, Todd B; Smith, Patrick J; White, William; Bisanar, Tiffany L; ... Mathew, Joseph P (2017). Resting-State Functional Connectivity and Cognition After Major Cardiac Surgery in Older Adults without Preoperative Cognitive Impairment: Preliminary Findings. J Am Geriatr Soc, 65(1). pp. e6-e12. 10.1111/jgs.14534. Retrieved from https://hdl.handle.net/10161/13329.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Alexander

John Hunter Peel Alexander

Professor of Medicine
John H. Alexander, MD, MHS is a cardiologist and Professor of Medicine in the Department of Medicine, Division of Cardiology at Duke University School of Medicine, as well as the Vice Chief, Clinical Research in the Division of Cardiology. He is the Director of Cardiovascular Research at the Duke Clinical Research Institute where he oversees a large group of clinical research faculty and a broad portfolio of cardiovascular clinical trials and observational clinical research programs. He is a
Berger

Miles Berger

Associate Professor of Anesthesiology
My research team focuses on 3 areas:1) We are interested in the mechanisms of postoperative neurocognitive disorders such as delirium, and the relationship between these disorders and Alzheimer's Disease and Related Dementias (ADRD). Towards these ends, we use a combination of methods including pre and postoperative CSF and blood sampling, functional neuroimaging, EEG recordings, rigorous biochemical assays, and cognitive testing and delirium screening. In the long run, this work has
Browndyke

Jeffrey Nicholas Browndyke

Associate Professor of Psychiatry and Behavioral Sciences
Dr. Browndyke is an Associate Professor of Behavioral Health & Neurosciences in the Department of Psychiatry & Behavioral Sciences.  He has a secondary appointment as Assistant Professor of Cardiovascular & Thoracic Surgery.Dr. Browndyke's research interests involve the use of advanced neurocognitive and neuroimaging techniques for perioperative contributions to delirium and later dementia risk, monitoring of late-life neuropathological disease progression, and inter
Gaca

Jeffrey Giles Gaca

Associate Professor of Surgery
Harshbarger

Todd B Harshbarger

Assistant Professor in Radiology
Mathew

Joseph P. Mathew

Jerry Reves, M.D. Distinguished Professor of Cardiac Anesthesiology
Current research interests include:1. The relationship between white matter patency, functional connectivity (fMRI) and neurocognitive function following cardiac surgery.2. The relationship between global and regional cortical beta-amyloid deposition and postoperative cognitive decline.3. The effect of lidocaine infusion upon neurocognitive function following cardiac surgery.4. The association between genotype and outcome after cardiac surgery.5. Atrial fibrillation
Newman

Mark Franklin Newman

Merel H. Harmel Distinguished Professor Emeritus of Anesthesiology
Best known for his work in assessing and improving clinical outcomes and quality of life following cardiac surgery, Dr. Mark Newman is President of the Duke Private Diagnostic Clinic (The Duke Faculty Practice Organization) and the Merel H. Harmel Professor of Anesthesiology at Duke University Medical Center. In addition, Dr. Newman developed the Multicenter Perioperative Outcomes Research Group of the Duke Clinical Research Institute established at Duke in 2001 to further the study of strategie
Smith

Patrick J Smith

Associate Professor in Psychiatry and Behavioral Sciences
Dr. Smith is interested in the impact of lifestyle interventions, such as diet and exercise, on neurocognitive function and mood. He has also published multiple studies examining the relationship between cardiovascular disease, major depressive disorder, and neurocognitive outcomes, preoperative predictors of postoperative delirium, the impact of cardiothoracic interventions on neurocognitive outcomes, and the relationship between patterns of dietary intake and cardiovascular outcomes. He is als
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Welsh-Bohmer

Kathleen Anne Welsh-Bohmer

Professor in Psychiatry and Behavioral Sciences
Dr. Kathleen Welsh-Bohmer is a Professor of Psychiatry with a secondary appointment in the Department of Neurology.   Clinically trained as a neuropsychologist, Dr. Welsh-Bohmer's research activities have been focused around developing effective prevention and treatment strategies to delay the onset of cognitive disorders occurring in later life.  From 2006 through 2018 she directed the Joseph and Kathleen Bryan Alzheimer’s Center
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